Home-based Health Care(HBHC): are women caregivers at risk? A study of Busia and Teso districts in Western Kenya.

CONTEXT

Most caregivers of people living with HIV/AIDS (PLWHA) in rural Kenya are women. In resource-limited situations, this can be a challenging and risky responsibility.

OBJECTIVE

Assess the risk factors to which home-based caregivers are exposed.

SETTING

Study of Home-based Health Care (HBHC) activities done in the Busia and Teso Districts of Western Kenya, with 824 patients under HBHC, from April 2004-April 2005. The Ministry of Health HBHC Policy in 2000 reduced bed-occupancy in Government Health facilities. Consequently, many AIDS-Related-Infections (ARI) patients, upon discharge, were nursed by relatives.

METHODS

Relevant information reviewed and data collected using: questionnaires; personal and key informant interviews (KII); and observation of caregivers' working conditions and protective measures.

RESULTS

The majority of home caregivers were women. Most caregivers (85%) were unaware of risks involved in PLWHA caregiving. Fifty-two percent had chest pains and coughs, 55% skin infections and 24% tuberculosis. Over 8% were found to be HIV+ upon testing at the Voluntary Counselling and Testing (VCT) clinic.

CONCLUSIONS

Women, and sometimes young children, assume the caregiving burden. Ignorance of risks and non-use of protection may predispose these caregivers to infections. Results point to the need for advocacy to improve the working conditions of home-based caregivers by primary health care policy makers. Finally, because the caregivers were sexually inactive, the caregivers that were HIV+ attributed their infections to nursing PLWHA.